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Health Reform May Help Those Who Spent Time in Jail

TUESDAY, March 4, 2014 (HealthDay News) -- The Affordable Care Act will give an estimated 4 million people who have spent time in U.S. jails better access to health care. This includes coverage for mental illness and substance-abuse problems that increase the risk for being rearrested, according to new research.

Unlike prisons, the nation's 3,200 local jails house people arrested for misdemeanors or nonviolent crimes. Many are mentally ill or homeless and are quickly released. But without access to health care or treatment, these people are more likely to be rearrested, the study authors noted.

"Health reform gives people with a history of jail time access to continuous health care for the first time ever," the study's lead author, Marsha Regenstein, a professor of health policy at the George Washington University School of Public Health and Health Services, said in a university news release. "The hope is that such coverage will help keep individuals and entire communities healthier and reduce the nation's health care costs."

The new legislation means people who have served time might be eligible for Medicaid coverage after their release from jail, said the study's co-author, Sara Rosenbaum, a professor of health law and policy at the university.

Many of them might also benefit from new Medicaid expansion programs intended to cover more low-income Americans, Rosenbaum said.

To date, 25 states and the District of Columbia have opted to expand their Medicaid programs. An estimated one out of six people who are expected to enroll in Medicaid under these programs will have spent time in jail in the past year, according to the analysis, which was published in the March issue of the journal Health Affairs.

Under the Affordable Care Act, people who are poor but do not qualify for Medicaid can purchase a health plan through the online insurance marketplaces. The research suggested that one out of 10 people enrolling in health plans through these insurance marketplaces will have recently spent time in jail.

"Enrolling people who are to be released from jail will require substantial effort and resources," Rosenbaum said. "However, this investment will pay off in terms of better health, reduced costs and possibly the reduced risk of additional jail time."

To make this happen, community jails and health care providers must help ensure that people released from jail sign up for Medicaid or a health care plan and follow up on their treatment, the researchers said.

About two-thirds of people sent to jail meet the criteria for mental illness at the time of their arrest, the study authors said. About the same number have problems with alcohol or drug abuse.